Tuesday, June 7, 2016

Ask a Vet: What Happens When Dogs Consume Meth?

Over the years, I have written about dogs and marijuana more times than I can count. Canine marijuana intoxication is very common — and, frankly, situations involving stoned dogs often are rather funny since stoned dogs tend to act … like stoners. Dogs “suffering” from marijuana intoxication may cause their owners to be gravely concerned, but I am comforted by the fact that it is almost impossible for a dog to die from marijuana exposure. (And if it weren’t for the publication of this paper, I would have omitted the word almost from the previous sentence.)

Medical marijuana is legal in many places, and recreational marijuana also is legal in some places. The general acceptance of marijuana in American culture means that plenty of upstanding people smoke or eat pot. When their dogs break into their stashes, there usually is nothing about the situation that is sketchy or creepy.

The same cannot be said for methamphetamine.

Meth by Shutterstock.

The dog who ran in circles

Several months ago, a 9-month-old terrier puppy was presented to my office. The owners complained that he couldn’t stop running in circles.

Indeed, he could not. He frenetically circled, always to his right. He barked almost incessantly. He dribbled urine uncontrollably. His heart rate was elevated, and his gums were redder than they should be. When a technician gently restrained him so that he could not circle, he responded by bobbing his head like an angry guest on the Maury show. He appeared to be highly intoxicated.

There are things besides meth that can cause these symptoms, and they’re not all illegal (although many of them are). For instance, ADHD medications contain amphetamines or amphetamine-like substances. Some antidepressants, in an overdose situation, can cause a condition called serotonin syndrome with symptoms such as the dog was exhibiting. Pseudoephedrine is a stimulant that is available over-the-counter as a nasal decongestant, and it can cause similar symptoms. Cocaine intoxication is not unheard of in dogs, nor is MDMA (ecstasy) intoxication. Certain neurological disorders also can cause the types of symptoms that the puppy exhibited.

I mentioned already that the dog was dribbling urine uncontrollably. This made it easier to get a diagnosis. A technician caught some of the urine in a cup, and we ran a drug test.

Believe it or not, over-the-counter drug tests for humans work well in most instances for dogs (the exception is when testing for marijuana, when false negatives are common). The dog tested negative for cocaine, opiates, benzodiazepines, and marijuana. He also tested negative for amphetamine, which ruled out most ADHD medications. However, the test lit up instantly as positive for methamphetamine. The dog was tweaking.

Vet checking dog’s eyes by Shutterstock.

Now I had to face the owners.

Owners of dogs who have consumed methamphetamine react to the diagnosis in one of two ways. Some owners freak out, wondering how the dog possibly could have been exposed to such a nefarious product. Marital or familial strife generally ensues (although it is entirely possible for dogs to find and consume meth in parks or even on the street). Other owners simply shrug or act embarrassed — they already know that meth is in the house, and they often already suspect what’s going on.

When I entered the exam room, I noted that the dog’s owners looked very respectable. Unlike many owners of meth-exposed dogs, they didn’t seem to be tweaking themselves. I braced myself for a freak-out, but instead got a shrug and a nod. Evidently, one can’t judge people by their appearance.

Treatment of methamphetamine intoxication involves sedation, and lots of it. A medication called acepromazine, which is related to thorazine, is the mainstay. Intravenous fluids are administered to help promote excretion of the drug by the kidneys. Some dogs require cardiac medications to control arrhythmias. Anti-nausea medications often are necessary to prevent vomiting, which in turn can lead to aspiration of vomit into the lungs. Blood pressure and electrocardiographic measurements must be taken frequently. Of course, all of this depends upon the owners consenting to (and paying for) treatment; many owners of meth dogs do not.

In this case, the owners consented to treatment. The dog did not require cardiac medications, and he recovered from his toxicosis overnight. He went home the following afternoon, little the worse for wear.

Unfortunately, not all meth dogs do so well. I remember another case from many years ago. I was working at a clinic near Golden Gate Park and the Haight-Ashbury district of San Francisco. Many homeless drug addicts reside in the area. I was in the process of performing a normal kitten wellness exam when I realized something was wrong. I heard what sounded like two dogs screaming relentlessly.

I left the exam room, and my suspicions were confirmed. Two young mixed-breed dogs were in the treatment area, vocalizing loudly and incessantly. Their pupils were dilated, their gums were pale, and their mouths were filled with vomit, which certainly had been aspirated by this point. Neither dog was responsive to any sort of stimulus.

The owners of the dogs looked like tweakers, and they promptly copped to what had happened. The dogs had consumed meth. Surprisingly, the owners consented to treatment. But the exposures were too severe. Both dogs died.

It will not surprise anyone to learn that meth is serious and bad stuff. Thankfully, I only see meth exposure a few times per year. Nonetheless, I cringe at the thought of the next dog who comes to my office after ingesting meth.